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PERMIT APPLICATION <br />CI�I( OF EVERETT PERMIT SER�/ICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />�0�- V <br />LEGAL LOTNO. BLOCK <br />DESC. <br />OWNER <br />0� � �. r1 012 <br />TENANTNAME <br />� RA T R� � C� �� <br />�� <br />CONTR. LICENSE #n��C�� �� <br />f� <br />USE OF BUILDING <br />PARCEL TAX I.D. # <br />t'� $ 311 <br />TRACT OR SUBDIVISION # <br />ADDRESS <br />.� �JI» �-A�T �Q��F <br />CONTACT FOIk PERMIT <br />4'���rt �-� I� <br />'E �M�I� ST�1o� <br />HEATSOURCE <br />Electric � Gas _ Other <br />���2-�v <br />PERMIT # / <br />D/ '� V <br />PHONE ^•,r ZSg� <br />T L7 <br />`j$ZU - 25 <br />10NE �Z� ��_ Ib9 <br />ma� <br />P ��ol �9�f - <br />� �3ob <br />CONTRACT PRICE OF WORK <br />� g53o� <br />WORKDESCRIPTION � IYAe.� E�/�`ST�� ��' .�%�`(�/�("� i,lJ I � I <br />E�FtC I ENT ���il R� r9eE � 1���3 f�,r�oJ� e Xis�Y� <br />w�t�1 N,�v�R� ►�,�►�l�es� w��� i��-r�2: C��s ,����,� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />BathWb <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/barlmop/etc.) <br />BackFlow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Ro�hof drains <br />�lAe� A,v —�-, Wfll`e� NY.�47'B� <br />N�.� 95`� <br />Elccr FtWT <br />-ra a�-r� � � <br />NO. I TYPE OF FI%NRE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust(an <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and knova the same to be true and correct. All provisions of laws and <br />ordinances governing lhis type of work will be complied with whether specified herein or not. The granting of a pertnit does net presume <br />to give authority io ��iolale or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I co:nply wi�h lhe <br />